Provider Demographics
NPI:1437477593
Name:COURTNEY, TRACY LAMAR (MD)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:LAMAR
Last Name:COURTNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3290 N RIDGE RD STE 240
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-3883
Mailing Address - Country:US
Mailing Address - Phone:410-730-6911
Mailing Address - Fax:410-730-1599
Practice Address - Street 1:3290 N RIDGE RD STE 240
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043
Practice Address - Country:US
Practice Address - Phone:410-730-6911
Practice Address - Fax:410-730-1599
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD869892084N0400X
KYR24432084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology